Young people who experience commercial sexual exploitation (CSE) have significant physical and psychological health problems either associated with or exacerbated by their exploitation. CSE survivors report more significant levels of negative health compared to non-exploited populations. Utilizing a sampling strategy informed by partnerships with specialized service providers who work with or specialize in responding to young people who experience or are at high risk of experiencing CSE, researchers recruited young people from around the county who have experienced CSE victimization or who are at high risk of such victimization to participate in an in-depth survey about their health care experiences. Surveys of youth were supplemented with interviews with adult survivors who experienced CSE victimization as minors, providing survivor narratives of their experiences seeking healthcare and meeting their healthcare needs across multiple stages of survivorship. Researchers found that young people who experience CSE or are at high risk of victimization largely have connections to healthcare. Most survey respondents have insurance, and most feel they have reliable access to healthcare, but they report a lack of trust in healthcare professionals, an unwillingness to disclose exploitation, and a belief that healthcare providers have not provided supportive care informed by their CSE experiences.

For decades, jurisdictions in the United States have relied on law enforcement and, in many states, mandatory arrest policies to address domestic violence (DV). The arrest-centered approach gained traction in the 1990s in response to community demands that the police take violence against women seriously and act decisively. This shift was intended to promote survivor safety and hold people who cause harm accountable. However, research reveals that prioritizing arrest to address DV can have unintended negative consequences. This report explores survivors’ experiences with arrests related to DV incidents in New York State. It underscores the urgent need for holistic, community-based strategies that prioritize survivor well-being and long-term safety. The findings also highlight the limitations of a law enforcement–centered response. By centering survivor voices, this study illuminates potential gaps in New York State’s current response to DV and provides recommendations to address the needs of survivors more holistically. Effective domestic violence (DV) solutions must address needs before, during, and after arrest. Although survivors seek safety, their needs extend beyond what the criminal justice system can provide. The complexity of the study participants’ stories reflects the complexity of the circumstances surrounding DV arrests and complicates public policy attempts at simple solutions.

Each year, more than 365,000 employees are charged with upholding incarcerated people’s protection while they are in custody. Corrections staff and their working conditions have historically been overlooked in research, but they are essential to better understand how to improve corrections’ employees’ overall well-being, reduce occupational risks, and increase recruitment and retention, especially during a staffing, recruitment, and retention crisis. Partnering with five state prisons in Colorado, Delaware, Iowa, Missouri, and Vermont and five local research institutions, the Urban Institute’s Prison Research and Innovation Initiative aimed to better understand and improve prison living and working conditions. This brief summarizes findings from three waves of climate surveys administered by local research partners to thousands of corrections staff in those five states. Corrections staff showed mixed levels of job satisfaction overall. For example, a large majority shared that they take pride in their job and that they positively influence incarcerated people through their work, but only about half said they look forward to coming to work. Staff were split on whether their workplaces ensure their safety. For example, less than half of staff felt their prison’s policies and practices support staff well-being, and less than half felt their prison’s leadership does everything possible to keep staff safe. Corrections staff rated COVID-19 responses positively overall, with a strong majority indicating that staff had access to sanitary items, were supplied with cleaning supplies and masks, and were wearing masks. But only half of staff felt their prison’s leadership demonstrated care for the well-being of staff during COVID-19.

Preparing students to transfer to a university and earn a bachelor’s degree has long been a primary mission of community colleges. However, only a fraction of community college students who intend to transfer ever complete a bachelor’s degree, and rates are even lower for low-income, older, male, Black, and Hispanic students. Though about 80% of community college students aspire to a bachelor’s degree, only 33% of them transfer to a four-year institution, and only 16% earn a bachelor’s degree within six years of starting college. In fall 2024, 52% of transfers came from the top two quintiles of neighborhood income and 27% came from the bottom two quintiles. Only 11% of low-income community college students earn a bachelor’s degree in six years. About 9% of Black students, 13% of Hispanic students, and 6% of older students earn a bachelor’s degree within six years of starting college. At public four-year institutions, 57% of community college transfer students complete a bachelor’s degree within four years after transferring. At private nonprofit four-year colleges and universities, 44% do so. Only 23%–25% of transfer students at private for-profit and predominantly online institutions complete a bachelor’s within four years of transferring. Black community college transfers are twice as likely as other students to enroll in these institutions. Many students transfer more than once or stop out before transfer. Many students graduate after six years or longer.

This working paper explores strategies to help K–12 schools sustain and enhance behavioral threat assessment and management programs over time. It identifies practices like defining measurable outcomes, integrating with existing behavior support systems, collecting and analyzing performance data, and maintaining continuous training that promote fairness, effectiveness, and school safety through ongoing improvement. As schools strive to ensure the safety and well-being of their communities, effective Behavioral Threat Assessment and Management (BTAM) programs play a pivotal role. The following key takeaways outline essential steps that schools should take to set themselves up for the continuous improvement of their BTAM programs, ensuring that these systems remain effective, fair, and responsive to emerging challenges. (1) Establish clear, collaboratively defined outcomes and measurable indicators of success at the outset of the design and implementation of a BTAM program, engaging BTAM team members and broader stakeholders to align goals and guide ongoing evaluation; (2) Integrate BTAM with existing school behavioral management frameworks and processes, such as positive behavioral interventions and supports or multitiered systems of support, to maximize resources, streamline practices, and promote consistency across student support systems; (3) Prioritize robust, ongoing training and capacity building for BTAM teams, ensuring members continuously possess multidisciplinary expertise and to avoid discontinuities caused by staff turnover; (4) Implement systematic, high-quality data collection and fidelity monitoring, using validated tools to track both individual and school-wide outcomes and rigorously assess intervention effectiveness and fairness; (5) Regularly review and analyze referral and outcome data, and solicit feedback from students, staff, families, and community partners to identify gaps, emerging trends, and areas for improvement in BTAM processes; and (6) Formally capture and institutionalize program improvements by updating policies, procedures, manuals, and training materials, ensuring that innovations and lessons learned translate into sustainable change over time.

The expansion of tribal casinos that began in the 1990s helped improve economic conditions faster for American Indians relative to the U.S. population as a whole. Specifically, after Congress passed the Indian Gaming Regulatory Act in 1988, the number of U.S. census tracts with an American Indian tribal casino operation surged from near zero in 1989 to nearly 600 by 2019. This paper aims to evaluate the zip code-level economic impact of tribal casinos on nearby people and places. Research shows that tribal casino operations boost wages for American Indians and reduce unemployment for nearby people of all races employed in casino-related industries (e.g., accommodation, food service, and arts and entertainment) when compared with non-casino reservation zip codes in the same state. Research also indicates that direct cash transfer programs (e.g., per capita payments of casino profits) may have contributed to improved living standards, on average, for tribal citizens living on reservations. In addition, economic conditions for American Indians living on reservations improved significantly as the tribal casino industry took off in the first two decades of the Indian Gaming Regulatory Act. American Indians living on reservation lands (regardless of the presence of a casino or cash transfer program) saw a 46.5% rise in real per capita income compared to 7.8% for the United States as a whole. However, added income wasn’t the only benefit of the passage of the act. For example, about an 11% decrease in childhood poverty compared to no significant change for the country as a whole and roughly 7% increase in labor force participation by American Indian women, compared to 3% for the country as a whole.

About a quarter (24%) of women who had their first child from 2020 to 2024 lived with an unmarried partner, up from around 17% in the early 1990s. But a smaller share of women had their first child while neither married nor living with a partner, dropping from roughly 20% to about 15% in 30 years. From 2020 to 2024, only about 4% of first-time mothers with a bachelor’s degree or higher were neither married nor living with a partner, and roughly 11% were cohabiting. During the same time, the estimated share of first-time mothers who were married at the time of birth remained at approximately 60%. Among those with less than a bachelor’s degree, fewer were married at first birth (roughly 40% this decade compared to about 60%) but the share living with a partner rose from about 20% to 35%. These educational differences highlight a growing divide in family stability: socioeconomically advantaged individuals are increasingly likely – and their less advantaged peers decreasingly likely – to be in stable arrangements such as marriage. Also, between 2020 and 2024, Asian mothers were the most likely to be married at first birth (87.1%), followed by White (71.3%), Hispanic (43.9%) and Black mothers (29.0%), though the difference between Hispanic and Black mothers is not statistically significant.

This brief describes how researchers can use unemployment insurance (UI) wage records to assess social and economic mobility. UI wage records are primarily used to administer the UI program, but they also offer researchers a detailed data source for viewing individual employment and earnings over time. These records contain individual-level information on quarterly wages and salaries and sometimes offer information on employers, hours or weeks worked, and occupation, making the wage records one of the few longitudinal administrative data sources tracking individual workers’ labor market outcomes. Researchers have used UI wage records to track how people’s earnings change over time and to study broader patterns of job mobility. Because the data provide consistent quarterly records, they’re especially useful for following individuals across years and evaluating the impacts of programs like job training or education. A big advantage is the ability to link UI records with other datasets, such as college enrollment or welfare participation, which lets researchers measure outcomes before and after interventions, such as employment levels, differences in incomes, and hours worked. This flexibility has made UI data a useful resource for studying both descriptive trends and causal effects in economic mobility. UI wage records face several limitations: access is costly, time consuming, and complex and often requires state-level agreements; they capture only taxable earnings from covered employment, excluding self-employment, informal work, and many federal or seasonal jobs; and they lack detail on job quality, hours worked, or worker satisfaction. Tracking individuals across states also can be difficult. Opportunities to increase access include centralizing and streamlining access processes, standardizing datasets across states, and linking UI records with other administrative data to enrich analyses.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence into adulthood. In 2023, about 15.5 million U.S. adults had an ADHD diagnosis, and more than one-half of those adults were first diagnosed in adulthood (55.9%). Health centers are local, community-based clinics that provide care to those who often encounter issues accessing health care. This report describes rates and characteristics of health center visits by adults with diagnosed ADHD, using data from the 2023 National Ambulatory Medical Care Survey Health Center. Key findings from the report include that (1) the health center visit rate for adults with attention-deficit/hyperactivity disorder (ADHD)was 52.6 visits per 10,000 adults in 2023 and decreased with increasing age; (2) among health center visits by adults with ADHD, most included a co-diagnosis of selected mental health disorders, including anxiety and mood disorders; (3) an estimated 40.1% of health center visits by adults with ADHD included a co-diagnosis of selected chronic conditions not related to mental health, including overweight or obesity (24.2% of visits); and (4) an estimated 41.7% of health center visits by adults with ADHD had a documented amphetamine prescription.

Lower out of pocket costs are coming for millions of people when the first Medicare-negotiated drug prices take effect on January 1, 2026. The 10 negotiated drugs are used by nearly 9 million Medicare Part D enrollees to treat conditions including heart disease, diabetes, autoimmune diseases, and cancer. According to the U.S. Centers for Medicare and Medicaid Services, the first Medicare-negotiated prices are substantially lower than what private Part D prescription drug plans were negotiating and could save enrollees a collective $1.5 billion in out-of-pocket expenses in 2026. Key takeaways from the report include that (1) the first 10 Medicare-negotiated drug prices will become available on January 1, 2026, and additional drugs will be selected and negotiated every year going forward; (2) Part D plan enrollee cost-sharing for these 10 drugs will decrease by an average of approximately 50% among stand-alone Part D plans that were available in five states with high Medicare enrollment; (3) Medicare drug price negotiation is currently working as anticipated and will reduce enrollees’ out-of-pocket costs in 2026, likely due to the prevalence of cost-sharing that is directly linked to drug prices; and (4) Ongoing efforts to exempt more drugs from Medicare drug price negotiation will negatively affect Part D enrollees by effectively eliminating the possibility of lower cost-sharing that could help improve enrollee access to those products.